Dygest's summary begins with a scene: a gay man nearing forty, living in a carefully decorated apartment, with a good job, a smart wardrobe, the right circle of friends, and a well-maintained body. On the surface he has won at life; but underneath there is always an unspeakable dissatisfaction, as if no amount of applause lands where the real wound is. This is the opening of psychologist Alan Downs's 2005 book The Velvet Rage. He is gay himself, and after treating gay male clients for many years he found the same pattern underneath many different lives.